tbuckley/cabot-search huggingface dataset:
Seeking Clarity About Intraoperative Anesthesia Patient Handovers
Authors: Richard C. Prielipp, Jeffery S. Vender, Douglas B. Coursin
Journal: JAMA (2022)

Patient care handovers (sometimes called handoffs) are organized transfers of pertinent patient information and responsibility between health care professionals. These handoffs are becoming more common as they represent an obligatory component of modern hospital care.
Recency of Online Physician Ratings
Authors: Weiguang Wang, Junjie Luo, Michelle Dugas, Guodong (Gordon) Gao, Ritu Agarwal, Rachel M. Werner
Journal: JAMA Internal Medicine (2022)

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POS0593 THE COURSE OF FATIGUE AND ITS RELATION WITH INFLAMMATION DURING THE DEVELOPMENT OF RHEUMATOID ARTHRITIS: A LONGITUDINAL STUDY
Authors: S. Khidir, F. Wouters, E. Van Mulligen, A. Van der Helm-van Mil
Journal: Annals of the Rheumatic Diseases (2022)

Background Fatigue is a prominent and disabling symptom in patients with rheumatoid arthritis (RA), that is only partially explained by inflammation and responds poorly to DMARD-therapy. We hypothesized that inflammation explains fatigue to a larger extent in the phase of clinically suspect arthralgia (CSA), when clinical arthritis is still absent and fatigue has not yet become chronic. Objectives To study the course of fatigue in CSA during progression to RA and the association with inflammation at CSA-onset and at RA-diagnosis. Methods 600 consecutive CSA-patients were followed for RA-development (median follow-up 25 months). Additionally, 710 early RA-patients were studied at diagnosis. Fatigue was assessed every study visit and expressed on a scale of 0-100. The DAS44-CRP was used to measure inflammation (with SJC=0 in CSA). The course of fatigue over time was studied with linear mixed models. Associations between fatigue and inflammation were studied with linear regression, corrected for sex. Analyses were stratified by ACPA-status. Results In 88 CSA-patients who developed RA, pre-arthritis fatigue-levels increased gradually with 7/year (95%CI= -2 to 16, p=0.13), towards 48 at RA-development. Fatigue decreased in CSA-patients who did not develop RA (-4/year, 95%CI= -6 to -3, p&lt;0.001) (see Figure 1). At CSA-onset, inflammation was associated with fatigue (β=18, meaning 18 points more fatigue per point increase DAS-score, 95%CI=7-28, p=0.001). This association was stronger than at RA-diagnosis (β=5, 95%CI=3-7, p&lt;0.001). Fatigue-levels increased towards RA-development in both ACPA-subtypes, but were on overall average higher in ACPA-negative CSA than ACPA-positive CSA (mean difference in fatigue of 13, 95%CI=1-24, p=0.027). However, the association between fatigue and inflammation was stronger in ACPA-positive compared to ACPA-negative CSA. Conclusion Fatigue increased gradually during progression from arthralgia to clinical arthritis, and fatigue was better explained by inflammation in CSA than in RA. This implies a ‘phase-dependent relation’ between inflammation and fatigue. References - Disclosure of Interests None declared.
Extracellular Vesicles May Predict Response to Radioembolization and Sorafenib Treatment in Advanced Hepatocellular Carcinoma: An Exploratory Analysis from the SORAMIC Trial
Authors: Timothy Wai Ho Shuen, Marianna Alunni-Fabbroni, Elif Öcal, Peter Malfertheiner, Moritz Wildgruber, Regina Schinner, Maciej Pech, Julia Benckert, Bruno Sangro, Christiane Kuhl, Antonio Gasbarrini, Pierce Kah Hoe Chow, Han Chong Toh, Jens Ricke
Journal: Clinical Cancer Research (2022)

Abstract Purpose: SORAMIC is a randomized controlled trial in patients with advanced hepatocellular carcinoma (HCC) undergoing sorafenib ± selective internal radiation therapy (SIRT). We investigated the value of extracellular vesicle (EV)-based proteomics for treatment response prediction. Experimental Design: The analysis population comprised 25 patients receiving SIRT+sorafenib and 20 patients receiving sorafenib alone. Patients were classified as responders or nonresponders based on changes in AFP and imaging or overall survival. Proteomic analysis was performed on plasma EVs by LC/MS, followed by bioinformatics analysis. Clinical relevance of candidate EV proteins was validated by survival and receiver-operating characteristic analysis with bootstrap internal sampling validation. Origin of circulating EV was explored by IHC staining of liver and tumor tissues and transcriptomics of blood cells. Results: Proteomic analysis identified 56 and 27 EV proteins that were differentially expressed in plasma EVs between responders and nonresponders receiving SIRT+sorafenib and sorafenib alone, respectively. High EV-GPX3/ACTR3 and low EV-ARHGAP1 were identified as candidate biomarkers at baseline from the 13 responders to SIRT+sorafenib with statistically significant AUC = 1 for all and bootstrap P values 2.23 × 10−5, 2.22 × 10−5, and 2.23 × 10−5, respectively. These patients showed reduced abundance of EV-VPS13A and EV-KALRN 6 to 9 weeks after combined treatment with significant AUC and bootstrap P values. In reverse, low GPX3 and high ARHGAP1 demonstrated better response to sorafenib monotherapy with AUC = 0.9697 and 0.9192 as well as bootstrap P values 8.34 × 10−5 and 7.98 × 10−4, respectively. HCC tumor was the likely origin of circulating EVs. Conclusions: In this exploratory study, EV-based proteomics predicted response to SIRT+sorafenib and sorafenib-only treatment in patients with advanced HCC of metabolic origin.
AB0305 RELATIONSHIP BETWEEN IMMUNOLOGICAL ASSESSMENT AND PERIODONTAL STATUS IN RHEUMATOID ARTHRITIS
Authors: A. Ben Salem, M. Brahem, C. Baccouche, R. Sarraj, O. Jomaa, R. Grassa, H. Hachfi, Y. Mohamed
Journal: Annals of the Rheumatic Diseases (2022)

Background Rheumatoid arthritis (RA) and Periodontitis are two chronic inflammatory diseases, which can share similarities such as the patho-physiological progression and immune regulation. Objectives The present study aimed to determine the link between immunological assessment and periodontal status in RA. Methods A cross sectional study including RA patients, which consulted or were hospitalized in Rheumatology department in Taher Sfar University Hospital of Mahdia Tunisia, between March 2020 and February 2021. The diagnosis of RA was based on ACR/EULAR 2010 criteria. Oral and periodontal examination was practiced by a trained dentist in the same hospital. Oral hygiene, teeth status (missing teeth) and paradental parameters (bleeding index of Loe and Silness (GI), plaque indexed O’Leary (PI)) were determined for each patient, to assess oral and periodontal diseases in RA. Results Our study included 73 patients with an average age of 51.7 years ±11.8 [21-74years]. Sixty-two patients (93.9 % of cases) were women, in which 35 (54.7%) were menopausal. Only one patient was a smoker. Nine patients (13.6% of cases) were diabetic. The mean duration of RA was 11.2 years ± 8.4 [10 months-37 years]. Rheumatoid factor (RF) was positive in 31 Patients (57 % of cases). Anti-citrullinated peptide antibodies (ACPA) were positive in 39 patients (72 %). Antinuclear antibodies (ANA) were positive in 5 patients (9.3%). Fifty patients (80.6%) had radiological impairments and 36 (54.5%) had specific deformations of RA. The disease activity score (DAS28-VS) and (DAS28-CRP) were very high (&gt;5.1) in respectively 14 patients (21.2%) and 8 patients (12%). Oral examination revealed xerostomia in 37 patients (62.7% of cases). Three patients (4.7% of cases) were toothless. Gingivitis was diagnosed in 45 Patients (65.2% of cases): localized in 13 patients (31.7%) and generalized in 28 patients (68.3%). Periodontitis was seen in 36 (50.7% of cases). Basing on bleeding index of Loe and Silness (GI), 36 patients (51.4%) had degree 2 and 11 patients (15.7%) had degree 3. Supragingival plaque and subgingival plaque were detected respectively in 62 patients (88.6 %) and 60 patients (88.2 %). We performed statistical analysis which showed that the positivity of ACPA was significantly associated with the presence of gingivitis. The RF or the ANA were not associated with periodontal abnormalities. Conclusion In addition to the functional handicap, rheumatoid arthritis has an impact on the oral status, which may be related to the immunological status of patients. Disclosure of Interests None declared
AB0833 Epicardial fat thickness: a novel marker of subclinical atherosclerosis in spondyloarthritis patients
Authors: A. Ben Tekaya, T. Mehmli, I. Ben Mrad, K. Mzoughi, O. Saidane, S. Bouden, R. Leila, R. Tekaya, I. Mahmoud, L. Abdelmoula
Journal: Annals of the Rheumatic Diseases (2022)

Background Chronic inflammatory process seems to be the underlying cause contributing to atherosclerosis in spondyloarthritis. Epicardial adipose tissue (EAT) which is the accumulation of visceral fat between the myocardium and the visceral layer of pericardium, is actually considered a novel cardiometabolic risk predictor (1). Recent studies have shown its association with the development of coronary atherosclerosis. Objectives The aim of our study was to assess the epicardial fat thickness (EFT) in patients with spondyloarthritis (SpA) in comparaison with healthy subjects. Methods We performed a prospective study including 47 patients meeting ASAS 2009 criteria for SpA compared to 47 healthy controls matched for age, gender and body mass index (BMI). Patients with history of cardiovascular risk factors or diseases were not included. Sociodemographic, clinical, biological and radiographic features related to the disease were recorded. All subjects underwent transthoracic echocardiography with measurement of EFT. Results SpA group included 33 men and 14 women, with a median age of 36 years (IQR: 28-46). Median BMI was 24.5 kg/m 2 (IQR: 20.7-26.8). Median systolic (SBP) and diastolic (DBP) blood pressure were respectively 121 mmHg (IQR: 110-130) and 71 mmHg (IQR: 67-78). Median disease duration was 11 years (IQR: 5-16). Median disease activity scores BASDAI and ASDAS-CRP were 2.6 (IQR: 1.8-3.8) and 2.18 (IQR: 1.62-2.91) respectively. Median CRP level was 6.45 mg/l (IQR: 1.5-19.9). Median BASFI and BASMI were 3 (IQR: 1.5-5.1) and 1.5 (IQR: 0-4) respectively. Coxitis was found in 53% of patients. SpA patients received: NSAIDs (92%), csDMARDs (51%) and TNF inhibitors (38 %). EFT was significantly increased in SpA patients compared with healthy controls; median EFT value was 3.1 mm (IQR: 2.5-4) versus 2.4 mm (IQR: 2-3) (p=0.001). Conclusion As an early marker of atherosclerosis, EFT was significantly higher in SpA patients, supporting clinical evidence of increased cardiovascular risk in SpA. Thus, more studies that involve larger samples should be conducted, using EFT to cardiovascular risk stratification in SpA. References [1]Katsiki N, Mikhailidis DP. Epicardial fat: a novel marker of subclinical atherosclerosis in clinical practice? Anatol J Cardiol. 2017 Jan;17(1):64–5. Disclosure of Interests None declared
AB0575 MESANGIAL C1Q DEPOSITION, BUT NOT C3 AND C1Q DEPOSITION IN OTHER RENAL COMPARTMENTS, IS A PREDICTOR OF RENAL OUTCOME IN LUPUS NEPHRITIS
Authors: T. Knežević, I. Padjen, V. Ivković, S. Bulimbašić, M. Ćorić, I. Jezic, Z. Biloglav, M. Laganović, B. Anic
Journal: Annals of the Rheumatic Diseases (2022)

Background Complement activation is an important pathophysiological process in the pathogenesis and development of systemic lupus erythematosus and lupus nephritis (LN). However, the prognostic value of complement factors deposition in different kidney compartments has received little attention and, to the best of our knowledge, no study examined its association with renal outcomes in LN. Objectives To evaluate prognostic significance of C1q and C3 complement factors in renal tissue compartments. Methods We have conducted a retrospective cohort study and collected data on demographics, clinical and laboratory parameters and histopathology (light, immunofluorescent and electron microsopy) at the time of biopsy and after long-term follow-up. C1q and C3 expression graded in different kidney compartments (mesangium, glomerular basement membrane (GBM), tubular basement membrane (TBM) and blood vessel wall) and dichotomized into no or low (grades 0 and 1) and high expression (grades 2 and 3). Remission (defined as complete or partial remission) was defined as per EULAR 2019 guidelines. Results A total of 51 patients with biopsy-proven LN were followed up for 4.5±2.9 years (80% women, mean age at biopsy 38±14). A total of 29 (71%) achieved complete or partial remission. Complement expression in different kidney compartments was as follows: mesangium (C1q 54%, C3 59%), GBM (C1q 34%, C3 41%), TBM (C1q 5%, C3 5%) and blood vessel wall (C1q 0%, C3 5%). Patients with proliferative lupus had more frequently C1q and C3 deposition in the mesangium (69% vs. 14%, p&lt;0.001 and 72% vs. 29%, p=0.005, respectively), while there were no differences between proliferative and non-proliferative LN in other renal compartments (all p&gt;0.05). Subjects who achieved remission more frequently had C1q deposition in the mesangium (64% vs. 31%, p=0.045), but there was no association between remission and deposition of C1q or C3 in other renal compartments (all p&gt;0.05). Interestingly, the association between C1q mesangial deposition and renal outcome was significant even after adjustment for age at biopsy, gender and lupus type (proliferative vs. non-proliferative) (OR 0.13 [0.02, 0.98], p=0.047). Conclusion C1q deposition in the mesangium might be an important prognostic factor in LN and more aggressive treatment of these patients may explain the better outcomes of these patients. Disclosure of Interests None declared
POS0624 RHEUMATOID ARTHRITIS AND ORAL MICROBIOME RELATED TO PERIODONTAL DISEASE
Authors: R. Dos-Santos, F. Otero, M. Varela García, E. Perez-Pampín, A. Mera Varela
Journal: Annals of the Rheumatic Diseases (2022)

Background Rheumatoid Arthritis (RA) is a prevalent systemic autoimmune disease with an unknown etiology. Its onset has been related with chronic immune activation. 1 Oral microbiome (OM) could be one trigger for this beginning, due to its implication in periodontal disease (PD) and chronic gum inflammation. 2 Objectives To correlate OM species potentially harmful and RA disease activity. Methods During a 6-month period (June to December 2021), RA patients (from the daily practice in a Rheumatology Department) and healthy controls were recruited. Healthy controls proceed from outpatient Orthopaedic Surgery Department (with no autoimmune diseases). A specialized odontologist made an oral evaluation and took samples. OM was assessed by a semiquantitative reactive-chain protein. Species evaluated were Porphyromonas gingivalis, Tanerella forthsytia, Treponema denticola, Prevotella intermedia y Aggregatibacter actinomycetemcomitans (PerioPOC, Austria). Results 237 RA patients and 83 healthy controls were recruited. 100% RA patients have, at least, one oral germ, as opposed to healthy controls (57.8%, p&lt;0.001). P. gingivalis was present in 60.2% RA patients treated with biological therapies, most of them anti-TNF. No healthy patients were carriers of P. gingivalis. 41% RA patients had the association of T. denticola and P. gingivalis, regardless of therapies used. The association of T. denticola, T. forsythia and P. gingivalis was also frequent. No relationship between biological therapies used and germs were found (p&lt;0.12). The coexistence of P. gingivalis and T. forsythia increases exponentially the risk of having a severe PD (x5, Figure 1). This is influenced also by higher age and smoking status. As well, this association was observed more frequently in RA patients versus healthy controls (x2.5). Conclusion RA is related with OM, regarding healthy controls. P. gingivalis is more frequent in RA patients that needed biological therapies. These therapies seem to not influence the presence of OM, being frequent the association of several species (symbiosis) causing PD. An OM and PD examination in RA patients could be beneficial to assess disease development and response to treatments, mainly if an eradication protocol is developed (based on local hygiene and periodontal treatment). References [1]Smolen JS, et al. Rheumatoid Arthritis. Nat Rev Dis Primers. 2018. [2]R Bodkhe, B Balakrishnan, V Taneja. The role of microbiome in rheumatoid arthritis treatment. Ther Adv Musculoskelet Dis. 2019;11:1759720. Disclosure of Interests None declared
POS1367 THE PREVALENCE AND RISK FACTORS FOR CARDIAC DISEASE IN PATIENTS WITH FAMILIAL MEDITERRANEAN FEVER
Authors: Y. Butbul, L. Gabay, Y. Braun-Moscovici
Journal: Annals of the Rheumatic Diseases (2022)

Background Familial Mediterranean fever (FMF) is a genetic disorder manifested by recurrent attacks of peritonitis, pleuritis and arthritis, and characterized by clinical and laboratory evidence for localized and systemic inflammation. Colchicine treatment usually prevents the attacks and the associated inflammation. Inflammation may play an important role in the initiation and progression of atherosclerosis. Recently colchicine was suggested as a therapy that help to prevent coronary heart disease. Objectives To study the effect of FMF and colchicine treatment on the cardiovascular morbidity and the overall mortality. Methods We studied using the data base from health insurance in Israel (Maccabi Healthcare Services-MHS) the presence of IHD and its risk factors in 492 FMF patients aged 40 years or more, and in a control groups matched by age gender and socioeconomic status. Results The incidence of cardiac disease in FMF patients was similar to the control group (6.5% vs 5.7% p- 0.594), smoking kidney disease and gout were higher in FMF compared to the control group (16.1 % vs 12.8% p- 0.022, 9.3% vs 5.1 p- 0.01 and 4.5% vs 0.2% p&lt;0.001 respectively), but hypertension and diabetes were similar. The overall mortality in average follow up of 3174.37 ±1738.84 days was similar in both groups. Conclusion The incidence of cardiac disease among FMF patients was not increased compared to the control group, despite the exposure to recurrent inflammation. We suggest that colchicine may have a protective role in these patients. Further studies are required. Acknowledgements I want to acknowledge Dr. Elad Asher for the support in the study Disclosure of Interests None declared
AB1353 VESSEL AFFECTION AND THE INFLUENCE OF GLUCOCORTICOIDS ON 18F-FLUORODEOXYGLUCOSE POSITRON EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY IN GIANT CELL ARTERITIS
Authors: L. Malich, F. Gühne, T. Hoffmann, A. Malich, P. Oelzner, G. Wolf, M. Freesmeyer, A. Pfeil
Journal: Annals of the Rheumatic Diseases (2022)

Background 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) represents one of the standard imaging modalities in the detection of giant cell arteritis (GCA). Detailed data regarding the vessel involvement in GCA are not available. Objectives The aim of this study was to quantify arterial vessel involvement at the onset of GCA by 18 F-FDG PET/CT and to verify the influence of glucocorticoid treatment on the diagnostic performance of 18 F-FDG PET/CT. Methods This study included 60 patients (44 women and 16 men, mean age 72.8 ± 8.8 years) at the onset of GCA. All patients received a PET/CT. 44 patients were glucocorticoid naïve. 16 patient were treated with glucocorticoid (prednisone median dose 60 mg) 3.5 ± 4.4 days before the 18 F-FDG PET/CT was performed. All 18 F-FDG PET/CT scans were scored regarding the active inflammation of the large arteries. Results The most affected arteries were the aorta ascendens (72 %), followed by truncus brachiocephalicus (62 %), acrus aortae (60 %), aorta descendens (60 %), left and right arteria sublcavia (60 % and 58 %). The aorta and their outgoing arteries presented an involvement in 39 GCA patients (89 %). A singular affection of the aorta was shown in 9 patients (20 %). glucocorticoid naïve patients (89 %) showed affected arteries more frequently than glucocorticoid treated patients (38 %). Conclusion The study showed that the thoracic aorta (in particular aorta ascendens) is the most involved vascular segment in GCA. The use of glucocorticoids was associated with a marked decrease of vascular inflammation. Consequently, the imaging of the thoracic aorta should be included in the diagnostic procedure of GCA. 18 F-FDG PET/CT should be performed without glucocorticoid treatment, if the clinical situation allowed this proceeding. Disclosure of Interests Leander Malich: None declared, Falk Gühne: None declared, Tobias Hoffmann: None declared, Ansgar Malich: None declared, Peter Oelzner: None declared, Gunter Wolf: None declared, Martin Freesmeyer: None declared, Alexander Pfeil Grant/research support from: This study is a part of the Investigator Initiated study Retrospective analysis of clinical and imaging parameters to predict flair in patients with giant cell arteritis.” which is supported by Chugai Pharma Germany GmbH, Lyoner Straße 15, 60528 Frankfurth am Main.